Loading...
HomeMy WebLinkAboutMiscellaneous - 138 OLD CART WAY 4/30/2018 �- 1 138 OLD CART WAY ` 210/107.6-0120-0000.0 - APPLICANT: WAGON WHEEL EST. . o � .�- -J ' 1MAP f LOT # -'� # 1 PARCEL'# / STREET (n ` c QQNSTRUMT-TION_A PDQ HAS PLAN REVIEW FEE BEEN PAID? YES NO PLAN' APPROVAL: ' DATE /G� AZ, APP. B DESIGNER: �yi C A6 PLAN DATE/ /qL CONDITIONS ' " - WATER SUPPLY: WELL WELL PERMIT DRILLER -_-_.-.________._ WELL TESTS: \�= CHEMICAL DATE APPROVED BApCTER_IA I DATE APPROVED....---...__._____.__. ,11 , BACTERIA II DATE APPROVED. COMMENTS: FORM U APPROVAL: APPROVAL TO ISSUE ES NO DATE ISSUEDZq � BY QJ ___----- CONDITIONS: FINAL APPROVAL: ALL PERMITS PAID NO WELL CONSTRUCTION APPROVAL NO SEPTIC SYSTEM CONSTRUCTION APPROVAL NO .. OTHER YES NO 1(T ��Q�11 ANY VARIANCE NEEDED YES NO G e- aNT FINAL BOARD OF HEALTH APPROVAL: DATE:_//�r BY:,- _ ''.•, .,. ' r BERT I_�S_Y_SI.E.M_�.N.�.I9.4L.,A_t.�_QN. . IS THE INSTALLER LICENSED? - AYES—� NO _._ TYPE OF CONSTRUCTION: - EWJ REPAIR NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW LYES--) NO CONDITIONS OF .APPROVAL YES NO (FROM FORM U> ISSUANCE OF DWC PERMIT YES NO DWC PERMIT N0. b O INSTALLER: BEGIN INSPECTION YES NO: ;+ EXCAVATION , INSPECTION: NEEDED: _ PASSED HY rt '� CONSTRUCTION INSPECTION: NEEDED: • - - _i - - u 1. AS BUILT PLAN SATISFACTORY: CY:E:S: , r APPROVAL TO BACKFILL: DATE: 7 BY� FINAL , GRADING APPROVAL: DATE /Z 9S BY FINAL CONSTRUCTION APPROVAL: DATE: _BY Board of Health g Lot CR North Andover, Mass ApplicantL" 10-1 c3/2� -- -' Water Supply Town Well Approved Date S.S . Septic System Design ,n Approved Date J I �X Approving AuthorityW&4,44* CONDITIONS+ Disapproved Date Reasons= DWC Septic System Installation Excavation Inspection Date Pass Fail Final Inspection Approved Date Approving Authority Additional Inspections (if any) Disapproved Date Reasons r t Final Approval Da+e Approving Authority a 4 CHECKLISF FOR PLAN REQUIREMENIS FOR SUBSURFACE SEWAGE DISPOSAL SYSTEMS TOWN OF NO. ANDOVER BOARD OF HEALTH MARCH, 1990 1. L.gUs_._Map._. (Suggested Scale: 1" = 2000' ) Locus identified. Streets and names within 1/2 mile. C. North arrow and scale 2. Site_P1_an (Suggested Scale: 1" = 207 ) ____......_......_.A. Lot to be served, its d i mens i ons and area. B. Fronting street. ........................ .. _...___ C. North arrow and scale. _ U. Assessor" s designation. __-- E. Abutters names and lot numbers. _ -�F. Easements. __._. G. Property lines. H. Footprint of proposed house to be served showing garage (attached or detached) . Where applicable setbacks to house. �J. Number of proposed bedrooms. Location and type of material ( if known) of driveway. .-L. Water service line from main in street or well. ------M. Locat ion of existing or proposed well. _-N. Location of deep observation holes and percolation tests. _........ O. Existing and proposed cent ours. Bench marks (2) and ties to proposed system leaching facility from bench marks or other permanent physical features (stonewalls, etc. ) -.Q. Location and dimensions of syntr. m (Septic tank, pipes and leaching facility) including the reserve area. ...,R. Profile and Section arrows. Location of any streams, water bodies, surface and subsurface drains, known sources of water supply within 200-feet, and wetlands within too-fvr (locate wetlands, specify type of resource and show 100-foot buffer zone line if applicable) . ------ Erosion control devices as r^eq u i red by Con. Comm. , Board of Health or Planning Board with detail and description of device proposed. ...............__....-.G- system components (sept is tar l(, U-ha>c, etc.) details should be provided ifother than nt.nnd-.rd as required from local supplier s. Component spec should be indicated somewhere on tale plans for standard items. Reviewed and r•ecomraerided by: ..................._..............._......................................_............. ..._........_.................................. i ...........__._............................ . Date i i I i i f i t REASONS (CONT. ) ---__----�..— ---- �. ----......... ._.._._...__._..-......—................__--_.—.._._........................................._.............................._...._........—...... RECOMMENDED ARRROVAL CONDITIONS/COMMENTS..____.__ _.......................... —._.............................._......_._......._............_................................................._..._........__.............. i s I � ' j d FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. APPLICA-NT ftLLS OUT THIS SECTtONi`"'"`*'`�`**'"'`* APPLICANT rMEML-D F E/stN PHONE '70 70 -3`�23 LOCATION: Assessor's Map Number /07 PARCEL /aO SUBDIVISION��A(;0,,�/ U/HEEL EST4TES LOT (S) 9/ STREET OLZ ( MT Gt1A y ST. NUMBER USE REC NDATIONS OF T WN AGENTS: CONS R TION ADMINISTRATOR DATE APPROVED {SATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED C I SPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS b PUBLIC WORKS -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDMG 4NSPE-CTAO DATE Revised 9197 jm y� FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: -s C��}i- �- �-5�= Phone LOCATION: Assessor' s Map Number 107.8 Parcel Subdivision (0a-L- lam/ &A Lot(s) L Street 010 G46Q7- `� St. Number 13Y ************************Official Use Only************************ /RECOMMENDATIONS OF TOWN AGENTS: 1U Date Approved Conservation Administrator --pp Date Rejected Comments �' bo- mit Date Approved Town Planner Date Rejected Comments Date Approved Food I motor-Health ..Date Rejected -1 Date Approved /- 7 /S ptic spector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date ,I 17 To �� P00rcv �Tto►J t T 2c��. 2c� ��p'Ttc ( NV �{-" )QVC T`rvD`rJ 2o2.gq 5s c6oEP, 2� -4 IN` SE�r1C ;T--A' 1C = 2 02 , 3 '1 uF7o1,l 8oX r �, Ir.� tJ ,, 43o r _ 202 • 2 l I. 7Iz1 cK "2 6q-Gi ` r=L-(3.OVJ3, f . „ oar p.^ ac, I _ r 2a (.4c� r�f� Tfz�yac{ ( 6` f t G 7, 2 q-:r1 .1 E �r r� i s Cil Q Tree"C H 2 . 2 r J +� 7 - 0 �; �Db F{ a I i r I . . i .,f kb orb• ACL P ri"/&(G ,S 1 1 JCH 4a PVG i �a`O�1 G. . � I N f I 4 t oL , I • � � pos0. to zC� o t 50 q- `1 ... c } .. tj u: PLAN r°� E ` � 4 O . tj ul Z)URFACE DI SYSTEg- 'LOCA­TED IN r 1U`of3 7T/--/ NO O _ ` z r t /* As . ; ,PREPARED FORi s crvtt � '' DOE : s—T 1-11 Y L °r LE:: I MERRIMACK ENGINEERING SERVICES, INC. I I PROFESSIONAL ENGINEERS • LAND W6EYORS • PLANNERS.' +;; - 66 PARK STREET • ANDOVER, MASSACHUSE0181.0 • TEL (5aH) 475-3555, 373.5721 ORT Town of � � Y Andover No. 576o �1rLl�,i dover, Mass., 19 T O �- LAKE COCKICKEWICK E BOARD OF PERMIeT T D . HEALTH Food/Kitchen Io. 01 Septic System �hk�'� 4TC.�csS'1� BUILDING INSPECTOR THIS CERTIFIES THAT... :.... .::...........:......... 1...........:........................................ ......................................................... Foundation has permission to erect..Q;f A .... {�.�.�.ri. .. . buildings on 1i.m.. t............... ..........: . .......: :%r�........:.:P:...X...... t to be occupied as..:�',�.� -r....�.A1r: iw �l la.;E?<<.,�lt.� — �?1i;.;s 4t C?`, li: .f���! .4� 4 ` voui ' _:4�.... � f[ � .:.......... ... .. ey . .. .. ....... .................. .. ...... . ... . ........ . .. provided that the person accepting this p rmit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection Alteration and Construction of Buildings in the Town of North Andover. PERMIT FOR FOUNDATION ONLY PLUMBING IN PECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. REGULATED BY PARA. 114.8-S. B.C. S Y * PERMIT EXPIRES IN 6 MOnff I FEE PAID t Final b-b . INSPEC UNLESS CONSTR� =ON STARTS br` PERMIT FOR FRAME/BUILDING ! � ............................................A................................. Service BUILDING INSPECTOR - FEE PAID: Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough No Lathing or Dry Wall To Be Done Final Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL street No. SEW ., /WATER FINAL DRIVEWAY ENTRY PERMIT Smoke Det. —,`? 771 : To fl �� Fo�r.Iv,��zorJ ?` ,. 2��. 2c, :.PTlc Ta*.►I� (IUV rVe �`r�►A`n1 = 2o2.9q �`+ eESs Cavell It I N' SEfs"TICrA:K'K 02. r7 2 3 CT fa'�1� +3 is T1 D N g o x r. ?,A Tr-E+a c I{ "2 S r/ E-�(3q�.V � `7•G - +`1;,3; ©u-r 2af•4o �s Frio. TfZ�r,Ic f-( �• 24:7 . (?�E Gr rpt 2 = 2 0 1.3 c) Com: : T(eEN C(-1 2 7 `fi 2 r. ._ a� �� ANO r � :•' = 20110 C. r if ti rig •• I, , Y ' sI LG PrP'«fG iS JCH 4 a P VL tt, if It ,. � ✓ � Off• LTi7 � - o o I+jOLE Q - �. ;fox )foo r;Au.otiG N sePnC ra NIC QVC -ME 5 w/ ouT�Er FLbr L i od c5 54 cAFZ t ABUILTli ; PLAN' t a� vM ,V►�" too S U RFACE DIS )SAL SE ` n L44TED IN 1U'0 7H 4 NOO V _ S {( alvigyp c aS; ;PREPARED FOR- C1YfL y ,. 15 .� , r ETWc y 6 0 � wH �� ; cQ �� s f �t, :AERRIMACK ENGINEERING SERVICES, INC. 'PROFESSIONAL ENGINEERS • LAND'SfVEYORS • PLANNERS: ' '.66 PARK STREET • ANDOVER, MASSACHUSETTS, D181'0 • TEL. (519) 475-3555, 373.5721 /a L O ,BH��� NET Q M , M AJ �� L P1638 rw& 1992 Warner Bros.,Ina N i ' I I � M I 0 r`�4• i Z(Q 2/ j 47 N I O/- 38 � C� OGD S .yERE�Y CeA-, Y TO TyE T/TLE 1AIS6wax.4V-0 �L or /Y TI7 7fIE B.4N,r T.VgT TNEOn'EGL/.�iG /% LOCATED O.V TiS/ELC7"ilSS,��,NANO Ti4G4T?pA�S CO.NFCtPq! //(/ !Y/Tf/ TiS�E TOwN• O/�iW A.voovE,� zON/NG ,�E6vGATi!'J.t/S � � ��/ ' Af �6+�I.eO/.K�s .fETdGIC.t'S F•PO.11 37�PEETS�fOT U.uES.� /�/O.C�T.�ir �.t/GY�✓E.�� /s'//,�S.S LOG4FTE0/�T ETFEDEE.4G fiO10O �2A O A.PE or O.PAN�IV ;�O.P • LSf/awn/0//F.Ar w t Nr,F 2so098 OOoBC /C .� .�E/,1GTy T to �2�93 J F P_L.S. GATE v ! S10�� ��. vEy0�' ivOT FO,P Bovvo.Py oEr ,v. BouvO,4.et�iriFo.P.H- �E.P.P//�1.9Gf'E'.I�GidEE.Pit/6 SE.Pv/CES AT/O.v TA,rE.t/ F,POiYI Exrsrit/c .eEco,POs. 6G �q.P,�.ST.rEET A.t/ODYE.� �1.4SS.vC.f�//SETTS O/8/O \ Town of North Andover, Massachusetts Form N0.3 j0Rrh BOARD OF HEALTH ot...o ,6�41, p 194 �f CHUS � DISPOSAL WORKS CONSTRUCTION PERMIT Applicant rlrl NAME ADDRESS TELEPHONE Site Location t_ Permission is hereby granted to Construct ( r Repair Sewage Disposal System as shown on the Design Approval S.S. No Individual Soil Absorption CHAIRMAN,BOARD OF HEALTH JU Fee D.W.C. No. ' Town of North Andover, Massachusetts Form No.2 f MOR7" BOARD OF HEALTH 11 19-9 O f w A •���"���R►►+��, DESIGN APPROVAL FOR ss"C""5`` SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant ` A&J- VIA-0-19 eQeflikIest No. a Site Location l C?-2„ C 'a L 1 )" Reference Plans and Specs.- ENGINEER DESIGN DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. CHAIRMAN,BOARD OF HEALTH Fee— , Site System Permit No. f -F ,el FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. *************/****Applica/nt fills out this section***************** APPLICANT: f/� 0 /���Ct� //ley 5z-" Phone l�S 7? LOCATION: Assessor's Map Number Al '7- Parcel 7 Subdivision w ,� �Ga-eye l ��f , << Lot(s) f/ Street U/Ce C St. Number ************************Official Use Only************************ RE NDAT S OF TOWN AGENTS: 1 11 G� Date Approved / z x'/- Co servat on Administrator Date Rejected Comments Date Approved 1 Town Planner Date Rejected ` Comments Date Approved Food Inspector-Health Date Rejected &, / Date Approved % a Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date MERRIMACK ENGINEERING SERVICES INC. [,[EU 1`�C °�n OF VQQMMEOUML Engineers • Surveyors • Planners 66 Park Street ANDOVER, MASSACHUSETTS 01810 DATE 1OB NO. IZ (617) 475.3555 —1 ' 2 ATTENTION ,UD 2TAM RE: TO g ARD OE' 14EA(J f w GDLC [✓�EF-C, �S F S'1; Yf S t S' _ WE ARE SENDING YOU ❑ Attached ,[❑ Under separate cover via the following items: ❑ Shop drawings rints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES DATE NO. DESCRIPTION 2 WY•!Z�II�gZ 04" or vW(-)G{_ T ;IOSA(a -3 d6' _,J l .1�'�l.l�Z It t1 /f 11 THESE ARE TRANSMITTED as checked below: ET"For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS WNogeb M PF2. 11tlU1Z e01` r1f=uT_S OF COPY TO SIGNED: S' Q®��j PNODUct240.2 Ees Inc,Groton,Mm 01471. If enclosures are not as noted, kindly notify us at once. DATE Sheet of BOARD OF HEALTH TOWN OF NORTH ANDOVER SUBSURFACE DISPOSAL DESIGN REVIEW FEEL D- Da PERMIT # DATE RECEIVED/D APPLICANT ASSESSOR'S MAP_ ADDRESS PARCEL # a 7 LOT # 02 STREET EGD C�4i71 Ay ENGINEER �� G � ADDRESS PLAN DATE /ej 112AZ- REVISION DATE CONDITIONS OF APPROVAL:_ SEC &5-Z,6 APPROVED DISAPPROVED R!)//V Y OUT-GWGG l06,Vr1oA/ '3/- PLAN REVIEW CHECKLIST ADDRESS �� DGD (2a/a&/ ENGINEER GENERAL 3 COPIES STAMP LOCUS ✓ NORTH ARROW,,,- * SCALE L CONTOURS ✓ PROFILEC/ SECTION L— BENCHMARK'S 56 SOIL & PERC INFO ELEVATIONS ✓ WETS. DISCLAIMER2----- WELLS & WETLANDS C".-' WATERSHED? DRIVEWAY (Elev) WATER LINE L— FDN DRAIN SCH40f/ TESTS CURRENT? SEPTIC TANK MIN 1500G. . 17 INVERT DROP C/ GARB. GRINDER���(+200% EDF) 25' TO CELLAR I_/ MANHOLE TO GRADEy ELEV GW 01C_ D-BOX SIZE -3 # LINES FIRST 2' LEVEL STATEMENT INLETZ0/.,!5D - OUTLET?-0/J3 _ • /? (2" OR . 17 FT) TEE REQ'D?Y-0 LEACHING RESERVE AREA L,-' 4 ' FROM PRIMARY? --" 100' TO WETLANDS v/ 2% SLOPE �.. 100' TO WELLS 35' TO FND & INTRCPTR DRAINS c/ 4' TO S.H.GWc- - 325' TO SURFACE H2O SUPPt/ 4' PERM. SOIL BELOW FACILITY. (/ MIN 12" COVER ✓ FILL? ✓(25' i above natural elev; 101if below) BREAKOUT MET?-L,--- - TRENCHES ET? t/TRENCHES , MIN 660 gpd v SLOPE (min .005 or 6"/1001 ) �/ >3' COVER? - VENT - SIDEWALL DIST. 2X EFF. W OR D (MIN 61 ) 1-,� IS RESERVE BETWEEN TRENCHES?_IZ IN FILL? t/ MUST BE 10' MIN. ✓ 411 PEA STONE? ne" BOT 306 X LDNG ��+ SIDE A64 X LDNG 4,0U = TOT �toll (L x W x #) (G/ft ) (DxLx2x#) �LN Commonwealth of Massachusetts RECEIVED City/Town of I JUN 1 1 2007 System Pumping Record TO Form 4 WN OF NORTH AN HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. The System Pumping Record must be submitted to the local Board.of-Health or other approving authority. . A. Facility Information Important: When filling out 1. System LOC8t10� forms on the computer,use only the tab key Address v- to move your dlf�lJ cursor-do not use the return City/rown State Zip Code .key. 2.. System.Owner: Name Address(if different from•iocation). City.frown StateZi Cone Telephone Number B. Pumping Record 1. Date.of Pum In � � P g bate 2. Quantity'Pumped Gallons 3. Type of system: 0 Cesspool(s) Septic Tank- ❑ Tight Tank ❑ Other(describe)" 4. Effluent Tee Filter present? ❑ Yes 8-140 If yes, was it cleaned? El Yet ❑ No 5. Condition Qf System: ^ 6. System Pumped 1 Name — Vehicle License Number Company 7. Location whei ntentts.were dispos . Signa'tur of ule Date http://www.mass.govl.dep/water/approval!§/t5forms.htm#inspect t5form4.doc•06l03 System Pumping Record•Page 1 of 1 • Commonwealth of Massachusetts City/Town of NOV 2 2010 System Pumping Record R NmoovEltForm 4 EPARTMENT M DEP has provided this form for.use by local Boards of Health. Other forms may be used, but the information must be,substantially the same as that provided here. Before using this form, check with your local Board of Health tQ determine the form they use. The System Pumping Record must be submitted to the local Board of Health o-othe'approving authority. A. Facility Information 1. System Locati �, r Right side of house, Left front of house, Right front of house, Left rear of house. Left rear of building. Right rear of building. Address ��� � p j� ,`/. � Cityrrown ` State Zip Code 2. System Owner: p ,( Name Address(if different from location) Citylrown Stat Zi C de Tere-plione Number B. Pumping Record CD 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes o If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Locati 7/� ntents were disposed: L.S.DLow I W Water Signature of a er Date t5form4.doc•06/03 System Pumping Record.Page 1 of 1 RFc i � Commonwealth of Massachusetts City/Town of ��V � System Pumping Record TQwNOFt�QRTHAND�i?�IER Form 4 HEALTH DEPAF'Th�tErtT DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left/Right front of house, Left/Right rear of house, Left/right Ide of house Le Right side of building, Left/Right front of building, Left/Right rear of building, Under dec c Address ( 3 �� � Citylrown State Zip Code lY� 2. System Owner: Name Address(if different from location) City/Town State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons ~ 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes Ei—fVo If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Locatio here contents were disposed: G.L S. Lowell Waste Water Sign t 'e Haule Date t5form4.doc•06/03 System Pumping Record•Page 1 of 7